Fluoroquinolones in acute exacerbation of chronic bronchitis and pneumonia- Drug selection by means of the SOJA method

The fluoroquinolone antibiotics are useful antimicrobial agents for the tre atment of a variety of infections. In the last few years several new fluoro quinolones, such as grepafloxacin, levofloxacin and trovafloxacin have been introduced in many countries. Trovafloxacin and grepafloxacin were recentl y withdrawn, due to serious side-effects on the liver and cardiovascular pr oblems respectively. This necessitates a critical evaluation of fluoroquino lones. In this article the fluoroquinolones ciprofloxacin and levofloxacin are scored by means of the SOJA method for two indications: exacerbation of chronic bronchitis and community acquired pneumonia. The following selecti on criteria were used: Number of indications (20), Number of formulations ( 20), AUC/MIC ratio (100), Variability of AUC (30), Drug interactions (70), Dosage frequency (70), Development of resistance (100), Clinical efficacy ( 250), Tolerability (140), Acquisition Cost (100), and Documentation (100). Levofloxacin showed the highest score for both indications.